Individual provider Active NPI

Michael Greene, LMSW

  • Clinical Social Worker
  • Little Neck, NY
National Provider Identifier
1962716332
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05430800 Issued in NJ
Practice address
24302 Northern Blvd
Little Neck, NY 11362-1150
Phone
(718) 423-6200
NPI assigned
Jul 28, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05430800 NJ Primary
Social Worker 104100000X 073545-1 NY

Addresses

Primary practice location

24302 Northern Blvd
Little Neck, NY 11362-1150

Mailing address

8134 190TH St
Jamaica, NY 11423-1041
Phone (718) 468-1809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110217000061 NY Practitioner - Clinical Social Worker 5496936957 Practice locations: Great Neck, NY
I20140910001180 NJ Practitioner - Clinical Social Worker 5496936957 Practice locations: Boonton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

550 W Main St
1 C/O Center for Mindful Change
Boonton, NJ 07005-1155
Phone (516) 350-0830

7 Bond St
1A
Great Neck, NY 11021-2412
Phone (576) 350-0830

8134 190TH St
Jamaica, NY 11423-1041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073545-1NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1962716332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8134 190TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114231041",
            "telephone_number": "718-468-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24302 NORTHERN BLVD",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621150",
            "telephone_number": "718-423-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05430800",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073545-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

Verify at the official NPI Registry.